ATTENTION AMERICA: ARE YOU NOT GETTING PROPERLY PAID ON YOUR INSURANCE CLAIM BY AN INSURANCE COMPANY? Do you ever get the feeling that the will of the American People and your best interests are being denied by those powerful few at the top? Nowhere is this more evident and illustrated repeatedly each day than in the insurance industry by the illegal actions of bad faith insurance companies! Bad faith insurance companies today employ the common and pervasive use of fraudulent deceptive practices to intentionally and illegally deny and/or withhold proper payment of policyholders legitimate claims. Simply, they do this in order to increase their company's profits and incentive for their own personal gains. Many bad faith insurance companies and their lawyers in addition knowingly victimize, use harassment, abusive, squeeze, stall and deny tactics as standard operating procedure to intentionally increase and add overwhelming hardships upon claimants, ultimately with the intent of rendering claimants weak and powerless, and many penniless, adversely affecting, devastating and ruining many hundreds of thousands upwards to as many as a million or more lives of claimants, innocent insureds and/or family members each year, all with the intention and objective of getting these claimants) to go away without collecting on their claim. These bad faith insurers and their deliberate despicable and ruthless actions have the devastating effect of leaving claimants destitute, homeless and/or either ending their lives or ruining their lives as they knew it forever. Such bad faith insurers actions are commonplace and happening more and more each day such that chances are good that it will happen to you, a family member and/or someone you know.

You don't believe or think that bad faith insurance will happen to you? Well, you are very wrong ... Just like those that we hear from everyday, some rich but mostly poor and middle class, that tell us "they didn't think it could happen to them! Bad faith insurance generally targets the greatest number of people, the poor and middle class and those least able to fight back, such as seniors and the elderly. That's because there are just more of them. We now know for certainty that the rich are just as likely to be the targets of breach of contract and bad faith insurance companies. Here's but one example for you to consider of how easily it could happen to you: that its not so much that if you are in a serious motor vehicle accident that its going to be your fault. To the contrary, the person at fault may most likely be the other person and chances are likely that they are insured by an FBIC high ranked bad faith insurer! Hartford, Allstate and State Farm insurance companies are rated the #1, #2 and #3 U.S. Worst Bad Faith Insurers!* State Farm (the U.S. largest auto insurer), Allstate and Hartford collectively insure upwards of some 50-60% of all automobiles in the U.S. today ... Add to that other bad faith large insurers (e.g. Farmers, Liberty Mutual, Nationwide, Progressive, etc.), chances are extremely good that the possibility and likelihood of this happening to you is some 70-75%. Don't let bad faith insurance happen to you or to your family! To your benefit and the benefit of your family and all Americans, we ask that you join FBIC America's buy good faith and boycott bad faith insurers Hartford, Allstate and State Farm and demand that they (and other bad faith insurers) immediately stop their illegal bad faith insurance claim practices ways, cease their predatory illegal bad faith insurance actions and our country's greatest crimes and abuses against the American People! (Attention: FBIC are not lawyers. If you are a claimant and/or an insured in need of legal help and are looking for a lawyer to advise or represent you or your family's interests, use our online website Find-A-Lawyer Directory ... Its free for claimants, consumers and businesses.)

BAD FAITH INSURANCE COMPLAINTS AND BAD FAITH INSURANCE CLAIMS PRACTICES.  Outraged about being wrongfully denied or being underpaid on an insurance claim for which you paid premiums? (If "No", then most likely you have not had an insurance claim recently ... but beware that when you do, chances are that you too will most likely have this unfortunate and common experience of today happen to you.) If "Yes", then join with the many hundreds of thousands or millions of fellow Americans and rapidly growing number in the more recent past few years who have experienced what is commonly known in the Insurance Industry as "Bad Faith Insurance".

WHAT ARE SOME OF THE POLICYHOLDERS BAD-FAITH RELATED COMPLAINTS, SIGNS OF BAD FAITH INSURANCE AND BAD FAITH INSURANCE CLAIMS PRACTICES? Bad things happen to innocent people who are the victims. Natural disasters occur, hurricanes and floods devastate areas and properties, buildings are impacted and houses burn or develop life-threatening infectious mold, airplanes and buses crash, trains collide, communities are rioted, crime-ridden and devastated, motor vehicle and automobile accidents kill and cause permanent disabilities to hundreds of thousands of victims every year, products malfunction and cause serious harm, people and children are exposed to toxins and dangerous chemicals are consumed unknowingly, workers are seriously hurt on the job, personal injury, medical malpractice and wrongful death occurrences are a common part of everyday life, and you suffer a catastrophic loss. We know from the many thousands of bad faith related complaints that bad faith insurers often use every possible device, ploy and tactic available to them to delay, deny, or discount claims whenever they can, even engaging in breach of contract and bad faith insurance claims settlement practices. In addition, large insurance companies, consumed with cost-cutting and increasing profits impose unfair restrictive guidelines on their claims adjusters making it near impossible to properly process a claim in a fair and timely manner.

The following are some examples of bad faith related complaints, indicators of bad faith insurance claims settlement practices and a few of the signs that may be indicative to make you aware that you are or may be dealing with a bad faith insurer. The following have been identified from policyholder complaints and compiled as some of the potential signs of bad faith insurance claim settlement practices. These signs are not meant to be offered as legal advice nor should be construed as legal advice. FBIC is an educational consumer advocacy as well as a media resource that specializes in identifying and ranking good and bad (faith) insurers based on their willingness to pay claims and their good faith and bad faith insurance claims settlement practices.  FBIC is neither a court of law nor legal counsel, so accordingly nothing indicated herein should be taken or construed as legal advice. In order to establish whether an insurer is in violation of "Bad Faith" insurance laws, "Unfair or Deceptive Insurance Claim Settlement Acts Or Practices" laws and/or is not acting in good faith must be decided and is determinable only by a court of law according to the specifics of the case, the court's applicable interpretation of statutes and case laws which may vary by state. When questioning or in doubt consult your state's bad faith insurance claims settlement practices and other pertinent statutes, case laws and key applicable court interpretations ... and most importantly, if you feel your insurer may be guilty of bad faith, unfair claims settlement practices and/or other pertinent illegal insurance practices and you feel you require legal advice, you should seek legal counsel from a licensed attorney admitted to the BAR and in good standing in your state or jurisdiction who is knowledgeable and familiar with the issues raised. (Click here to read FBIC's "Legal Disclaimer and Copyright".)  As indicated and subject to a court's specific findings in each case and state, click on the following link to view:

FBIC (FIGHT BAD-FAITH INSURANCE COMPANIES).   FBIC, founded in 1997, is a tax exempt non-profit, public interest consumer advocacy organization and educational media resource that specializes in identifying and ranking good and bad insurers based on policyholders bad faith related complaints, the company's good faith and bad faith insurance practices. FBIC educates, informs and helps consumers and businesses to fight back against bad faith insurers that deny and/or withhold proper payment of Policyholders and Claimants legitimate claims. In addition, FBIC works with the media and press in researching, investigating and uncovering today's rapidly growing fraudulent multi-billion dollar bad faith non-payment of claims rip-offs by the powerful Insurance Industry's bad faith insurers. FBIC recognizes that in order to stop bad faith insurers from intentionally committing bad faith as a common practice against the American People, requires change and attention to three areas which include legislative, judicial and that which FBIC believes to be the most important and powerful of all, the American People, empowering consumers not to buy insurance from bad faith insurers. Legislatively, FBIC feels that the laws need to be changed to be made fair and equitable for both insureds and insurers, however the powerful are the first to admit behind closed doors that laws are meant to be broken and that the laws are there for the little guys ... so changing the laws may/will help but probably not very much especially if the change is meant to be just for viewing by the Public. Judicially, the courts probably won't get any closer in helping to level the playing field in bad faith insurance complaint cases between insurers and insureds in the next two hundred years than they have in the past two hundred years. FBIC knows that the key to real change lies with the success of the FBIC Citizens Action Movement and the continuing support of the American People.

There are three key elements to buying insurance: (1) Price (2) Insurer financial strength aka Solvency (3) Whether the insurer pays its claims promptly and properly in good faith or instead willingly (aka intentionally) denies payment of claims promptly and/or properly in bad faith, an area of expertise that is exclusive to FBIC. Consumers should consult insurers or their agents for a price quote, reference the appropriate financial reporting agencies for insurers financial strength and solvency information (Note: FBIC finds the available information provided by these agencies seriously flawed as it has been indicated that these financial ratings agencies are highly conflicted as they are alleged to be bought and paid for by the insurers who pay the financial rating agencies to establish and report their ratings from information not only supplied them by the insurers but who also pay the agencies to establish and report the insurer’s rating. According to the rules and regulations of the industry, if the insurer is not happy or satisfied with the first agency’s report and rating, it has the option to suppress its publication and go elsewhere to have a second financial rating agency report and rating done. In addition, it has been alleged that there is one agency that financially rates insurers that is not paid by insurers, that is Weiss Ratings, out of a total of approximately four or five widely used financial rating agencies that are paid by insurers to rate them, which include A.M. Best, Fitch, Moody's and S&P (aka Standard & Poors). A 1995 study by the GAO indicated that Weiss and Moody’s assigned insurers fewer top ratings out of the five agencies providing the service. FYI, FBIC is not associated with these agencies and assumes no responsibility for these agencies insurers financial ratings or any other insurer ratings.

FBIC is a nationally recognized non-profit consumer advocacy and educational media resource organization which researches, compiles and utilizes extensive data to be able to identify and rank insurers according to their good faith practices and willingness to properly pay claims vs. bad faith insurers which 'willingly' delay, discount or deny payment of claims. FBIC is the only organization and source to nationally rank and rate insurance companies based on the insurers good faith or bad faith practices, their record in paying claims and paying them properly, which includes insurers bad faith non-payment of claims records, consumer complaints and related improper actions against policyholders and claimants. FBIC receives no compensation from insurers for providing this service. FBIC is supported by donations from the public.

FYI, there are in excess of 40 private industry associations and organizations nationwide representing insurance companies most in the name of fighting consumer fraud perpetrated against insurance companies. State government DOIs (Departments of Insurance) are in charge and supposed to be regulating and monitoring insurers practices actions but none to our knowledge have ever intervened and/or acted against an insurer for their bad faith actions to protect their state’s citizens and consumers. In other words and in the history of states insurance regulation, no DOI to our knowledge has ever individually or collectively looked at and connected the dots of each consumers bad faith complaints against each of the bad faith insurers. So what Americans are left with is a situation where both good and bad faith insurers are left to self-police their companies and industry’s bad faith related complaints and actions. Well, you would think by now that with all of the illegal actions and corruption of businesses, mutual funds, and elsewhere by those in power uncovered on Wall Street, one might think that those in charge, in power or in authority in the state legislature, regulatory authorities and those charged with oversight would investigate, but in this case there is no one doing the job. There is however one organization (and only one to our knowledge) helping educate policyholders and assisting claimants in fighting back against the pervasive illegal actions and practices of bad faith insurance companies and their breach of contract and bad faith claim settlement practices, and that organization is "FBIC". As FBIC is supported by donations from the public, we ask for your donation and contribution which makes it possible for FBIC to continue to make great strides at educating and stopping bad faith insurers from victimizing the American People.

YOUR STATE DEPARTMENT OF INSURANCE (DOI) ... FRIEND OR FOE? (Part 1)  Each state has a DOI (Department Of Insurance) whose responsibility is to regulate insurance companies practices within their state, to make sure insurers are financially solvent and stay within the state's laws and "are supposed" to protect its citizens from bad faith insurers and when insurers break the law. So, with state government DOI (Department Of Insurance) Agency oversight, how do insurance companies get away with unfair and bad faith claim settlement practices and not paying legitimate claims? This is commonly and routinely done by bad faith insurers claiming to the DOI that they are investigating the facts in the matter when in many cases they are not (generally, there is no time limitations attached to insurer alleged investigations esp. when it comes to matters of fact or factual matters) ... also by stalling, distorting the truth, use of deception and diversion tactics, and denying, denying, denying. In legal terms these actions are collectively referred to as "Unfair and Deceptive Claim Settlement Practices".

Sometimes the DOI will follow-up on a complaint and call the insurer to get an explanation as to the complaint. When a bad faith insurer gets such a call, generally all they want to do in order to get off the hook when the DOI makes an inquiry (usually that amounts to a telephone call to the insurer's administrator handling the case), bad faith insurers can easily claim they are investigating the matter (when they are not), stretch the truths by indicating and claiming one thing and then illegally do something else or just the opposite. Knowing that there is no properly staffed state governmental agency armed with the incentive and necessary essentials seriously investigating and looking into these practices, there is nothing to stop bad faith insurers which easily take advantage. Furthermore, as a result of investigations initiated by the NY State Attorney General into widespread corruption and fraud by many moreso larger insurers in late 2004 and spreading nationwide, it has come out and been found that many of the country's larger insurers have just repeatedly outright lied in the past to state Department of insurance commissions, both verbally and in writing ... and in most cases involving consumer complaints sided with the insurer which is generally their usual style. Generally, the state DOI Department is way understaffed. Generally they may get to investigate 10-13% of claimants complaints which usually at best involves a phone call from the state Examiner to the insurer asking a question about the case or claim. The insurer responds, the DOI gives the benefit of any doubt to the insurer over the claimant and takes the word of the insurer generally resulting in making a note in the file which usually settles and satisfies the examiners inquiry most any question and in one minute or less closes the file.

Believing that the state governmental DOI agency has investigators (which generally they don't) or examiners seriously investigating and looking into the insurers practices is a joke, and the insurers know it and there is nothing to stop bad faith insurers which easily take advantage. In such cases, the insurer may indicate any number of responses to the DOI examiner that: (1) they are denying the claim for any reason that they feel is best, or (2) the first reason that comes to mind right or wrong, that they know will work on getting the DOI off their back, or (3) they are investigating the claim. The first two reasons generally enables and allows the DOI and insurer to close the file on the claim, as each writes a note in his/her file even in spite of the claimant contesting that the reason is completely bogus and/or has nothing to do with the case. In this case, the examiner usually says well you better speak directly with the insurer as we are closing the file and generally when the claimant speaks with the insurer, the insurer might indicate something completely different or indicate repeatedly they have not received the paperwork, one of their most frequently used and popular reasons at some point or another in many if not most all cases. The complaints are marked as unjustified and/or closed by the DOIs and the insurer(s). In this manner, some 10-13% of the total complaints in as many cases are classified as investigated by the DOI with most obviously indicated as unjustified by their computer records. Generally, even though the examiners know which insurers are offering mostly to underpay and those insurers that are denying most of the brunt of the number of complaints involving claims exceeding $1,000 to $15,000, depending upon the insurer, even if there were 5,000 claims consecutively denied one after the other, it is generally agreed by experts and those in the know that no one at any state DOI has the incentive or makes any effort to connect the dots of insurers bad faith activities ... leaving this area wide-open to abuse. Generally, the basis of DOI individual complaint related claimant investigations is whatever the insurer says. Otherwise, the only way insurers get exposed and caught for their illegal and fraudulent claim practices is by complainants or Whistleblowers" working in combination with FBIC, an investigation by the Media and/or The Press.

The most shocking news and reality of it all, as supported by highly regarded experts and knowledgeable others in the industry along with some of the most well respected media and journalists quietly agree as it is well-known and no secret that DOIs are heavily conflicted and cannot do their jobs to protect consumers. DOI actions that occur on behalf and on the side of the consumer are rare if not non-existent in most if not all bad faith related complaints and insurance cases. The only related consumer complaints that ultimately get any attention by the DOI are those that address minor administrative infraction situations, otherwise DOI lack of actions ultimately sides against the consumer and in support of the insurer. See it for yourself. (In order to view any of the videos on this website, you will need Windows Media Player or Real Network RealOne Player installed on your computer. To download the latest FREE version of Windows Media Player click here or to download the latest FREE version of RealOne Player click here).   To view the following investigative video by NBC Dateline called "Dangerous Liaisons" revealing the behind the scenes covert dealings of former California Department Of Insurance (DOI) Commissioner Chuck Quackenbush with six major insurers regarding California's 1994 Northridge earthquake victims who to this day because of these illicit dealings many claimants have yet to be properly compensated, click here.   The video exposes just the kind of illicit dealings and deceptive anti-consumer actions that are purported to be common and that have gone on behind the scenes between state insurance commissioners and the insurance companies they are supposed to be regulating on behalf of their citizens, the very people they are there to protect and who are the victims of such illicit deals. One state, believed Louisiana, has had three consecutive former state Insurance Commissioners go to prison for getting caught doing illegal things related to their jobs.

SmartMoney Magazine published in its February 1999 edition an article which cites some of the real facts and truths about state DOI (Department Of Insurance) actions regarding claimants and insureds (who the DOI is supposed to protect), and insurers (which the DOI is supposed to regulate) entitled "10 Things Your Insurer Won't Tell You", which cites:

BAD FAITH RELATED COMPLAINTS AND BAD FAITH INSURERS TRANSCEND ALL LINES OF INSURANCE ... THAT INCLUDES HEALTH, LIFE AND DISABILITY INSURANCE TOO ... BIG TIME. The media, primarily network television (along with a few newspapers), have exposed some of the growing number of bad faith insurance occurrences, many of which are highlighted by cases within our country's predominantly insurance based managed healthcare system. These exposés take many months if not several years to investigate and produce. In the investigation confirmed by video, even after the insurer is found to be guilty as judged by any reasonable person and caught dead to rights with their pants down, bad faith insurers under no circumstances admit to guilt even though you have seen it happen with your own two eyes. The same holds true for Court cases and trials where the bad faith insurer is found guilty. No matter how damning and overwhelming the evidence and the findings, the bad faith insurer still swears to their innocence ... and refuses to accept guilt insisting that everyone (even their own employees) were misjudged and/or misunderstood.

If you haven't read in between the lines yet, research indicates (and it should come of no surprise) that bad faith insurers (and their lawyers) are highly vindictive and vengeful. It is repeatedly proven that bad faith insurers, when confronting a policyholder with a claim in many or most cases these days, turn viciously adversarial and are well known to engage in a bitter fight as necessary to the end during which time they utilize the most unconscionable tactics and limitless resources available to them to do whatever is necessary to get the claimant to go away without being properly compensated on their claim for the insurance coverage for which they paid their premiums ... in doing so the bad faith insurer hopes to be spared from having to payout on a (legitimate) claim while their attorney maximizes their firm's highly paid billing hours. It is proven that bad faith insurers and their defense attorneys are bullies of the worst kind as are well known by claimants, their victims ... and accordingly will stop short of nothing, exercise no constraint, spare no abuse, utilize the extreme powers available to them to overpower and spare no expense in crushing the smallest of adversaries (similar in proportion to that of an NFL championship professional football team beating their chests in playing against an elementary school 1st grade football team and playing as if they were in the superbowl or better yet as described by some claimants as nothing short of murder or that of a serial killer).

Responsibility and accountability for bad faith insurers treachery, lies, deceptions and actions must start at the very top with senior-most management bearing the brunt of the blame for his company. But FBIC has found and learned through the years that in many cases it is not the President or senior-most management of the larger bad faith insurers that is always to blame. On the contrary many if not most of the time, it is middle management and the everyday operational lines people and staff that is to blame. What FBIC has found and identified is that bad faith insurers are notoriously cheap and accordingly much of the time hire under-educated and untrained workers without high school diplomas or a G.E.D. to understand and administer complaints. For the most part, these individuals have no formal education and are uneducated and untrained as to processing insurance claims for example ... and their positions in general are that of a used car salesperson (nothing disparaging intended against used car salespeople, except that this is not the type of individuals that should be charged and responsible for peoples lives). To make matters worse, these staffers are hired and immediately put in a claims processing or related position without any or minimal adequate training. Bad faith insurers make no investment to have and send them to a college or institute of insurance management. (In older days gone by, we have slight recollection as to Lloyds of London and Zurich having such schools for their employees to be trained). This is without a doubt the primary problematic area especially associated with bad faith insurers that is endemic to the entire insurance industry. Having identified this problematic area, we have also found that every bad faith insurance company case/claims manager should be criminally charged with violations of the RICO Act as they continue on an ongoing purposeful direction to exhibit repeated acts of criminal behavior which is also the truest form of domestic terrorism that this country has ever seen.

For those having difficulties dealing with bad faith insurers, it is important for consumers to know that an experienced and good "plaintiff insurance trial attorney" can usually handle the rough play ... and the best part, these trial lawyers specializing in plaintiff insurance cases work on a contingency basis meaning it only costs you a percentage of the claim and/or award if they win for you.) Our best guess is that this rough play is what bad faith insurance companies that repeatedly commit breach of contract and fraud and consistently break the law believe they have to do to hopefully get you to go away and for them not to get caught. Then again what first-graders lack in power, they make up for in energy, pure candor, creative thinking and then some. So, the FBIC America Movement on behalf of all Americans says let's play the game and beat the bad (faith) boys our own way and win: FBIC asks that you and all Americans buy good faith and boycott bad faith insurers.

The bad faith nature of insurance cases happens to upwards of tens to hundreds of thousands of Americans each day in healthcare alone. They occur mostly when health insureds go to the hospital, when they go for an office visit with their doctor and/or pick up a prescription at their pharmacy and are denied payment for a covered procedure and/or prescription(s) for various reasons (i.e. an outright computerized denial for payment as not covered for various reasons, or possibly just that the insurers computers are down or not working which means that the only way the patient will be able to pick up the medication is by paying for it. (Do you know how much money an insurer can save by their computers being down for a day or hours ... its in the millions). Another example is when an insured is made to pay a higher co-pay than they are aware their policy calls for. The list goes on and on. If you don't already know as an insured, ask your doctor or pharmacist how many times a day this occurs to their patients. In some cases this may be the result of a confusing and complicated system advocated and intentionally setup by insurers to confuse consumers and are part and parcel of bad faith insurance. (FYI, insurers oppose any standardization of their system and industry.) Even with legislation to try to correct a part of the situation or system , many/most if not all insurers fail to comply with the new legislation. This is bad faith insurance.

Next, bad faith insurance almost invariably happens again when the insured gets their bill from the hospital and/or from their doctor's office showing examinations and procedures as being denied and not paid for by the insurance company. Again, this is bad faith insurance. (e.g. The longer the insurer has the use of the insureds money for investment purposes, called "the float", the more money the insurer makes and the greater its profits). Whether it involves the pharmacy where you get your meds, your doctor's office or emergency room visit or stay at a hospital, it takes someone with time and great fortitude to go back and forth many times between the insurer, the pharmacist, the doctor's office and/or hospital administrator before the claim(s) are paid (that is if you are lucky and the claims ever gets paid at all). You don't believe it? Again, then ask your doctor, pharmacist or hospital administrator how many times a day this occurs. Again, this is bad faith insurance.

Again and again, we see the same stall-starve-deny-deny and stall-stall, starve-starve and deny-deny-deny-deny tactics repeated over and over again. These are all forms of bad faith insurance which are no different than the bad faith insurance employed with Life, Homeowners, Auto, Disability, Workers Compensation or Property & Casualty lines of insurance, etc. ... it is merely an extension of how bad faith insurers operate in general. Whether it be out of disgust, frustration, concern for your credit rating or fear of collection legal action being taken against you, paying these denied or unpaid claims yourself merely rewards bad faith insurers especially as this is exactly what they want you to do. And if you think any "Patients Bill of Rights" will prevent such bad faith occurrences, you are wrong ... they will simply continue on because no laws can prevent bad faith insurance from happening when the bad faith insurer intentionally, unscrupulously and repeatedly utilizes their illegal stalling, distorting of the truth, diversion, deception, starving-out and denying tactics in order to avoid paying claims and improve their bottom line profits. Whether they blame it on their system or not and get away with it, the truth of the matter is, is that it is bad faith insurance. FYI, bad faith insurance companies operate in the same illegal and deceptive ways across all lines of insurance including and not limited to Life, Health And Disability insurance lines, along with Auto, Homeowner, Property & Casualty And Workers Compensation insurance lines, etc. and they number amongst the largest companies and most powerful institutions in our United States.

Bad faith insurers are sending a clear message to insureds not to submit a claim and that if you submit a claim, you will pay severe consequences ... if your claim gets paid, your insurer will either cancel you or if you are lucky increase your premium 500% even if you have never had a claim before. No area of insurance hits closer to home and the tone of this message than in the arena of homeowner insurance in both large and small claims. Click here to view an "Eye On America Investigation" report by CBS News regarding an example of one such insured who made a claim on his homeowners policy to his insurer, State Farm, the price that was paid and result for making a claim and also exposes the little known about and secretive insurance industry C.L.U.E. system. FYI, the C.L.U.E. (Comprehensive Loss Underwriting Exchange) personal auto and homeowner insurance database system details for all Property & Casualty insurers the past insurance automobile and homeowner claims filed by all consumers and provides information about related claims filed on their policies. Many of those who are privy to the system contend that there are many information mistakes of a substantive nature in the C.L.U.E. system as there are in consumers credit reports. We also have another bad faith insurer video exposé in the homeowner insurance claim's arena. Recently, toxic mold claims have been given special attention and in some cases taken front stage for all insurers but moreso for bad faith insurers who want to avoid and not pay toxic mold homeowner claims not only because of the magnitude of the claim and financial expense that can be incurred in coverage but also because of the devastation that toxic mold can wreak on the health of the homeowner and its residents. Click here to view an investigative exposé called "Breaking The Mold" by CourtTV on the bad faith insurance claim response by Farmers Insurance to a homeowner policyholder and toxic mold claimant.

POLICYHOLDERS COMPLAINTS OF LIFE INSURANCE & ANNUITIES COMPANIES FRAUDULENT PRACTICES ... MUCH MORE COMMON THAN YOU WOULD EXPECT. It is cited by experts and confirmed by the media that "Life Insurance" fraud and misrepresentation is a huge and very real problem in America. Although hard to believe but certainly borne out in part by the ensuing events, a team of life insurance fraud experts in 1997 estimated that no less than 40% of all life insurance policies written since 1983 would not perform as promised at the time of sale. Furthermore, estimates are that 3 out of every 5 policies sold in the United States between 1980 and 1994 have potentially been sold under false pretenses. It has been claimed that "40 percent of life insurance sales people are somewhat less than honest or would steal your last dime … the remaining 59% are loyal, ethical, honest, caring professionals who would not harm anyone in any way, shape, or form. Unfortunately, if this majority were to be presented with a case of fraud, misrepresentation, or deceit against theirs or any other insurance company, they will turn their head and do nothing about it. They take no personal interest in these situations and delegate their fiduciary responsibility to lawyers, State Dept. of Insurance investigators or the companies themselves (FBIC Note: Don't expect them to do anything to resolve the matter esp. if it concerns $$$$. Ultimately and most likely you will need a lawyer to help settle any disputes you might have with your insurance company).

There is no doubt that when it comes to life insurance and financial planning, knowledgeable, honest agents representing quality companies are very important. Unfortunately, many people have discovered too late that their best interest was not given a high priority by their insurance agent." Before we delve further into any wrongdoings, let's review a little history to bring the most common fraudulent life insurance companies practices into better perspective

Many people remember that in the 1950's it was quite common for insurance agents to go the homes of life insurance policyholders each month to collect premiums. These Debit Agents, often the only link between insurance companies and policy owners, collected premiums as low as 12 to 15 cents per month. These agents were commonly treated like part of the family and were welcomed at Christmas and Thanksgiving celebrations. When new babies were born, these "family members" would often bring groceries, gifts, and financial aid to the new mother and child. When the newborn was old enough, the agent would be there to sell the parents a new policy on its life and so-forth and so-on. It was not at all uncommon for the insurance agent to be named as the baby's godfather or even have it named after him. As the child grew, so too would the size of the policy. A $500 policy might at some point become a $2,500 policy and later on have its face value increased to $10,000 or $15,000. By the time a youngster reached 18 years of age, his/her policy may have been "rewritten" numerous times.

When modifying existing policies, insurance agents would often take a policy's existing equity or cash value and "roll it over" into another policy sometimes increasing the death benefit substantially. Using an in-force policy's cash value in this way would sometimes offset a new policy's premium so that it would remain level for quite some time.

Beginning in the late 70s, huge numbers of these policies were converted to a plan called Universal or Flexible Premium Life. While only similar to Whole or Traditional Life, a Universal policy is basically a Term plan with a savings account built into it. If, for example, the policyholder made their monthly premium payment of $70, $10 would be automatically applied to cover the cost of the premium and the additional $60 would be placed into an interest bearing savings account that paid as much as 11% interest in the 1980s. As the policy owner grew older, the internal cost of insurance would increase. Statistically speaking, "the older you get – the closer you get to death". This can be easily understood when one considers the cost of insuring a 60 year-old person versus an 18 year-old. The 60 year-old is closer to death, therefore the risk and/or cost of insuring the older person will be greater. As the years passed, the internal cost of insurance would increase automatically from $10 to $20, $30, $40, $50 and continue upwards. In order to offset these huge costs of insurance later in life, policyholders overpaid heavily in the beginning so that the savings could offset the cost increases later in life. Although designed to keep the policy "alive" until needed, agents would sometimes represent that this money could be withdrawn at any time, for mortgage completion, college education, retirement income or any number of other reasons.

With Whole Life or Term policies, the insurance companies were required by law to secure the policy cash value and subsequently were unable to invest the premiums. Needless to say, not being able to invest this huge amount of money bothered them greatly. Years later when the laws were changed and the insurance companies were no longer considered fiduciaries the question was asked, "How do these companies get their hands on all the cash held in these old policies?" The answer was an easy one. The insurance companies needed to simply give the names of the policy owners to the agents and instruct them to convert all this business over to Universal Life. Once this had been done, the insurance companies could invest all that money at its own discretion.

Insurers and agents advised policy holders with money in passbook savings accounts usually earning possibly only 2% at their local bank to "invest" some or all of this money into Flexible Premium Universal Life plans with the insurer. Here, they claimed, their money would earn 6, 8, or even 10% - sometimes even more. In many cases the policyholders were told they could withdraw money from these plans to supplement their retirement supplements, mortgage pay-off, second home, college funds, etc. Unfortunately, after doing exactly as their agent instructed, too many people in due time watched their policies destroy themselves and eventually lapse without value. Here's how the policies became worthless.

By design, the interest on the savings portion of a policy is used to offset the increasing cost of life insurance as the insured gets older. As a policyholder ages and the associated costs increase to the point where the costs exceeds the interest from savings, the insurer takes this excess cost out of the principal in the savings account. Hmmm? A number of years ago when the agent sold me the policy, the agent told me that I would have a paid up policy for the rest of my life. Where is the agent now? Let me call the company. "Oh, the agent is no longer with the company." "The agent never told me that if I didn't increase the amount of the premium that over time I would lose the cash value of my policy and eventually the policy would become worthless." 'Vanishing Premium' fraud is just that. It's when the agent sells a policy and the policyholder has no knowledge and is unaware that the policy could eventually lapse due to lack of premium. (More on vanishing premium fraud in a second).

Fraudulent Life Insurance Practices:

'Churning' is when agents use a misleading sales practice in which policyholders are persuaded to use the cash value in their older life insurance policy(s) to buy a newer one(s): (a) they don't necessarily need, and/or (b) by falsely contending that the new policies are cheaper or provided more coverage. Churning is illegal and is one of the most common claims of fraud made by life insurance victims.

'Vanishing premium' is an option that may allow a policy owner to stop paying premiums after a certain number of years. Vanishing premium fraud is when an agent: (a) because interest rates or dividends were so high, falsely promises the customer that the new policy(s) would pay for themselves in only 7 or 8 years, (b) falsely predicts to customers that the cash value in their policy will perform so well that they won't need to pay future premiums and/or can use it to pay for future premiums until the policy is paid up. This misrepresentation of a "vanishing premium" is illegal and another cause for action against insurers.

In 2000 the SEC cited 80 percent of life insurance companies for failure to follow regulations related to life insurance sales in the 80's and 90's. Of the infractions, 20 percent were serious enough to warrant further investigation and possible penalties.

John Stoia, a San Diego partner in the law firm of Milberg, Weiss, Bershad, Hynes & Lerach, which handled numerous lawsuits and cases against many of the country's leading life insurers for improper and/or fraudulent churning and vanishing practices said, "There are in excess of 1,800 life-insurance companies in the country and the vast majority were engaged in this behavior through the 80's. The lawsuits generally contend that agents -- who stood to gain a lot in commissions when they sold new policies -- misled customers by telling them that if they replaced their old life insurance policies with new ones providing double-digit returns, they would get more coverage and the new policies would virtually pay for themselves. Some companies actually armed their agents with sales literature on vanishing premiums."

According to most of the suits, the agents didn't adequately explain that premiums for new policies would start higher simply because customers were older, or warn them that interest rates were likely to fall eventually, forcing up premiums.

Sales of the new and replacement policies hit a record year for insurers implicated in the scandal. But as time went by interest rates declined and legions of policyholders found themselves confronting higher premiums than they had ever imagined. Many people, unable to keep up the payments, let policies lapse and lost everything they had put into them.

Some every day examples of sales which beg questioning includes: (a) why would a man nearly seventy five years old pay almost $26,000 for a life insurance policy that would only last 6 or 7 years then lapse without any value while he was still alive? (b) why would a married couple in their late 60s with two perfectly good life insurance policies that have substantial cash values "roll over" them for new ones that would only last a few years before becoming worthless? (They would all have to die very soon in order for their policies to be any good.)

Prudential. In 1996, involving a class action suit against Prudential, the nation's largest life insurer, it was determined that 11.5 million potential fraud victim policyholders existed within that company alone. It was expected that Prudential would pay over $2.8 billion to settle class-action suits during the years 1983-1991. It was estimated that less than 10% of those victimized would actually be made whole by this class suit. Assuming another 5% will "opt out" or choose not to participate in the class, this leaves approximately 9 million people hanging onto policies that will never benefit anyone.

Metropolitan Life (Metlife). In August 1999, The Metropolitan Life Insurance Company, the nation's second-largest life insurer, agreed to pay $1.7 billion dollars to settle lawsuits and claims accusing the company of cheating an estimated 10.7 million policies sold to 9 million potential fraud victim customers through deceptive sales practices during the years 1982-1995.

Numerous other big names in the industry were also implicated in the fraudulent practices scheme affecting upwards of 50 million policyholder victims. Such big names (following in bold) along with other companies (not in bold) affecting policies and policyholders victims included New York Life with an estimated 7.5 million, John Hancock Mutual Life affecting an estimated 6.8 million and Guardian Life an estimated 5.5 million. Even though these and over 40 other different life insurers have been sued in recent years for similar practices, investigations, lawsuits and proof that some of these types of fraud have been committed, are still ongoing within these companies and continue to be found. Numerous cases against Prudential, MetLife, New York Life, Allstate and John Hancock have surfaced since reaching settlement. Fraudulent sales practices such as these also exist too within fraternal organizations like The Aid Association For Lutherans have also been found. Among the partial list of companies found caught up in such improper and/or fraudulent practices is a veritable "Who's Who" of life insurance. They include: The Aid Association For Lutherans, Allmerica Financial Services Inc. (fmrly State Mutual Life Assur.), American Express/IDS Life, American Family Life Insurance, American General Life & Accident Insurance Co., American Income Life, American United Life Insurance, Berkshire Mutual Life Insurance Co., CIGNA (Connecticut General) Life, Crown Life, Equitable Life (now AXA Equitable Life), Franklin Life Insurance Co., General American Life, Guardian Life Insurance Co., Great West Life, Hartford Life Insurance Co., Jefferson-Pilot Life Insurance Co., John Hancock Mutual Life Insurance Co., Life Insurance Company of Virginia, LifeUSA, Manufacturers Life Insurance Co., Mass (Massachusetts) Mutual Life Insurance Co., Metropolitan Life (MetLife) Insurance Co., National Life (VT), New York Mutual (MONY) Life Insurance Co. of New York, Nationwide, New England Life Insurance Co., New York Life, Northwestern Mutual Life, Pacific Life, Phoenix Home Life Mutual Insurance Co., Principal Mutual Life Insurance Co., Prudential Insurance Co. of America, State Farm Life Insurance Co., SunAmerica Inc., Sun Life Assurance Co. of Canada US, Transamerica Occidental Life Insurance Co.

Other Fraudulent Life Insurance Practices:

'Premium Misdirection' - You have a Universal Life policy from 10 years ago (with a substantial cash value higher than your premiums) and are paying a flexible premium of $100.00 a month. Your wife has a term policy from work. Your sales agent says you can lower the $100.00 per month premium on your policy and reduce it to $30. Then with the $70 a month amount saved you can use it to pay for a new life policy on your wife. Unfortunately, what you are not being told as time goes on and you get older, the cost of your policy increases and unless you increase the premium amount being paid, the cash value of your policy eventually or in short time will be depleted and go down to "0". At this point now that there is some cash value in your wife's policy that you purchased, you stop paying the $70 monthly premium payment being paid on your wife's policy and re-increase payment on your policy back to $100 monthly not realizing that the cost of your wife's policy also increases, depleting the cash value of your wife's policy down to "0" (unless you also increase the premium being paid on that policy as well). Ultimately, both policies are out of money.

'Piggy-backing' - is where an agent or you take the equity from one policy to buy another policy on the same person and over the course of say 10-20 years, this is being done for many policies.

'Forging' and 'Windowing' - is where an agent or you take a new service policy, forges one's signature from an old signature and in order to distort the forged signature 'faxes' it to the home office. Once you authorize with the agent to take the cash value of an existing policy(s), a dishonest agent is now able to scan your signature and do anything with it. (So you say your agent is honest do you? It is estimated that 60% of agents are not honest or not as honest as you expect them to be. Click here to read "Life Insurance: Never Trust A Salesman". )

How Could Such Widespread Life Insurance Fraud Have Happened?

The sales practices that may seem plausible on the surface herein lies the ongoing conflict of interest and battle of consumer vs. insurer when translated down to claims (i.e. bad faith claims), or in the case of life insurance claims or redemption where the policyholder ultimately finds their policy to be worth -0- or to be completely worthless. These cases just further go to illustrate the state Departments of Insurance and NAIC being in the pockets of the giant insurers as well as their duplicitous nature whereby when it comes to claims or life insurance policy redemption, as shown herein, the insurer generally wins out 99.9% of the time. In this case this event rated an "11" on a scale of 1-10 and was so enormous and egregious affecting almost everyone with a life insurance policy, more than 50 million Americans, that the regulatory authorities had no choice but to "cite the insurers infractions" and go on allowing the policyholders' to proceed with class actions and private court actions to redeem whatever they could.

Remember that insurers even as defendants use the courts to their benefit.

Adding insult to injury, as a result of the legal actions brought at the time, many of these actions resulted in policyholders receiving such things as coupons and the like to hopefully be able to redeem some of the value of the insurance policy(s) they had lost due to the fraudulent actions of those companies and agents involved. The ironic part is that due to the "rigged" remedies put in place to help make victims whole (they are rarely if ever made whole) and correct these illegal actions, life insurance companies ultimately sold more new policies in the year or two following the court actions than ever before in their history. Thanks to our states Departments of insurance and the NAIC and their hidden conflicts and agendas, the bottom line here is that insurers by their illegal actions in fact bring more money to their insurance companies and damage the policyholders. Subsequently, a small crop of former life insurance agents have become investigators for policyholders who expect or have found that they too have been scammed. If you know FBIC's credibility and the credibility of this website, then you know that all information on this website, (except for FBIC proprietary information), is documented, referenced and supported by reputable media and expert sources. To read further on the subject of life insurance frauds, click here to go directly to our "Library Reference Page Section on Life Insurance Fraud".

ANNUITY

Among the alleged even more abusive sales practices are those sellers of variable annuities many of which are the same as those found caught up in shady life insurance sales. The fraudulent and improper sales practices included the following:

'Churning' and 'Excessive Fees'. The unnecessary replacement of old variable annuities with new ones to create unnecessary commission payments and surrender fees.

'False Disclosures'. Failure to disclose investment risks or misrepresenting tax deferral benefits that can be achieved through variable annuity investments. Falsely touting variable annuity products of one company over identical products of another in order to generate commissions and surrender fees.

'Preferential and Unfair Customer Treatment'. Side agreements between the seller and certain large or favored investors to allow "market-timing" and "after hours trading" in which favored customers are allowed to rapidly buy and sell variable annuities, harming long-term investors who are not allowed to participate in the practice by diluting the profits they would otherwise receive and concentrating or increasing their losses.

'Unsuitable Sales Into Tax-Deferred Accounts'. The unsuitable investment or transfer of funds in tax-deferred accounts such as IRAs, Keoghs, Rollovers, 401(k)s, profit sharing, and other qualified retirement plans, subjecting such investors to higher and additional classes of fees, as well as unnecessary termination costs and restrictions, and lower overall investment returns.

Policyholders were charged "exorbitant deferred annuity insurance fees" for a double tax deferral they cannot use.

To read further on the subject of annuity fraud, click here to go directly to our "Library Reference Page Section on Annuity Fraud".

LIFE INSURANCE UNCLAIMED POLICIES ... ARE BAD FAITH INSURERS WITHHOLDING HUNDREDS OF BILLIONS OF DOLLARS OF UNCLAIMED LIFE INSURANCE BENEFITS THAT THE PEOPLE AND STATE GOVERNMENTS ARE BEING CHEATED OUT OF?

There is over 400 billion dollars in unclaimed money in the United States held by banks, life insurance companies, other companies and governments. Although the value and amount of unclaimed life insurance benefits due from paid up life insurance policies of deceaseds is not known, life insurance companies are among the largest holders of paid up and dormant life insurance policies unclaimed benefits. There is no state or federal agency or national database or clearinghouse where consumers can go to find out information on unclaimed and unpaid life insurance policies benefits or locate missing or unknown policies.

It is commonly reported by many life insurance companies that represent and claim that they aggressively search for beneficiaries of deceaseds paid up policies unclaimed benefits that are in their possession. Many if not most life insurers indicate that less than only 1% of paid up policies where benefits and moneys are due to beneficiaries go unclaimed. Less than 1% seems like an unreasonably small number and very unlikely in today's world when you consider the speed of everyday life where more things happen in less time, where each year billions of dollars become lost and unclaimed when institutions lose track of deceaseds, beneficiaries and the true owners of money or unclaimed life insurance benefits, where mistakes by the post office scanning machines, misspelled names, businesses and banks bankruptcies, acquisitions and mergers, people and family members lives take so many different directions, twists and turns, marital divorce, couples breakup, job relocations, and changes of address are so frequent, common and lost, that we don't even know the names of our neighbors. On the other hand contrary to many insurers claims and representations, it is reported that insurers expend very little or no effort to find the beneficiaries of the unclaimed policies. It is estimated and reported by knowledgeable sources outside the venue of the inner circles of life insurance companies that upwards of 25-30% of all life insurance policy benefits are never claimed and go unpaid upon the death of insureds because beneficiaries and/or family members don't know that a policy exists, don't bother to do any due any sort of investigation or search or if they suspect that a policy exists, are unable to find the company that is the holder of the policy where benefits are due and unclaimed.

Insurers generally agree that it is up to the beneficiary to notify the insurer of a policy owner's death. That being the case, if it is the responsibility of the beneficiary or interested party to notify the insurer of the deceased policyholder's demise and no one steps forward to notify the insurer of a policy owner's death, contrary to life insurers claims and representations, in many if not most of these particular cases where no one notified the insurer and the insurer didn't know of the policy owner's death , why would "insurers have reason to aggressively search for beneficiaries of unclaimed benefits of deceaseds" if they had no knowledge of the policyholder's death in the first place. In this light life insurance companies representations that less than 1% of deceaseds policies where benefits are due go unclaimed and that they aggressively search for beneficiaries are now suspect and leads the rest of us to believe that the insurers representations in this case at the very least are questionable if not an outright false statement. Also questionable if not potentially an outright false statement, many other insurance companies insist they do not measure how many life insurance policies go unclaimed as it is difficult if not impossible to gauge. They indicate and represent that their companies have no way of knowing that a lapsed policy belongs to a dead person. Insurance companies generally will take steps to find out why a policyholder stopped making payments by sending out letters informing the policyholder that if payments are not made covering the amount of the unpaid premiums, the policy may lapse. If the insured does not respond to the letters, the insurer may make other efforts to locate the insured otherwise the company will classify the status of the policy to lapsed. So how can so many life insurers be correct in representing that less than 1% of deceaseds policy benefits go unclaimed when so many other life insurers indicate that there is no way to know and they have no way of knowing that a policyholder with a paid up policy has deceased and is the reason for the policy being unclaimed.

Nevertheless, if the insurer is unable to find or contact the beneficiaries, the policy benefits due go unclaimed and unpaid. In this case and in general, it is the responsibility of a beneficiary to find the unknown insurer to make a claim for the benefits due from a deceased's life insurance policy that has not been paid. In order to track down the insurance carrier of a deceased's unclaimed life insurance policy and hopefully secure payment for the benefit, it most often becomes necessary for the beneficiary to undertake an investigation which can be extensive, cumbersome and time intensive to find the insurer that holds and is in possession of the deceased's policy and benefits. If a beneficiary believes that a policy existed but does not know the identity of the insurer, the investigation process can start with contacting the major life insurers directly. In addition, it is recommended to look through a deceased's personal papers, address book and telephone numbers for information regarding the existence of insurance policy documents and names of insurance agents. In addition, contact the employee benefits office at all former places of employment and their union offices. Look through the deceased's recent bills going back one year or more looking for any annual or monthly premium notices. Inspect the deceased's financial records, bank statements and tax returns looking for any indication of payments made or dividends that may have been received from an insurance company.

In addition to the amount of the unclaimed policy benefits, beneficiaries may be entitled to much more than the value of the policy as a growing number of mutual life insurance companies have converted from being owned by its policyholders to being a publicly traded stock company owned by shareholders (aka demutualization). The financial benefits continue to accrue after a company demutualizes. In addition to the benefits of the policy, the beneficiary may also be entitled to receive stock, benefit from the growth of an appreciated share price, policy credits, cash payments due from stock dividends, and other benefits in consideration and exchange for their ownership interest in the old mutual insurance company. It is reported that millions of policyholders aren't aware they are entitled to receive compensation worth billions of dollars from the company's demutualization which will go unclaimed as the demutualized insurance companies claim they do not have current mailing addresses for millions of their former mutual policyholders. For example, it is estimated that 95% of union members have a group life insurance policy paid by their employer that has never been claimed. The same may apply if supplemental insurance was purchased through the employer.

Sometimes collecting the benefits due on a missing life insurance policy can be easy and sometimes very difficult. Beneficiaries can usually find a life insurance policy if its within a year after the insured dies and in this case claiming the death benefit from the insurer should be relatively easy. If a few years have passed since the deceased passed away, it becomes more difficult and contacting the state for help is suggested. You first need to determine if the deceased insured had term life (aka insurance only in effect for a period of time i.e. like renting a policy) or whole life (aka permanent i.e. owning a policy) insurance.

If the insured had term insurance, the policy's benefits are only due and paid if the deceased dies during the term the life insurance is in effect and before the end of the term while the policy is still in effect. With term life insurance if the deceased dies after the date the term ends, no benefits are due to be paid.

If the deceased insured had whole life insurance, benefits are due to be paid if the death occurred while the policy was in force meaning that all premium payments were made up until the time of death. If the death had occurred previously some time ago, benefits are due to be paid with interest from the date that the deceased passes away. However, if the insured stopped paying the premiums before they died causing the policy to lapse, there is the possibility that the benefits may not be due and the beneficiary would not be paid. When a whole life policy lapses, in most cases it depends upon the policy and options determined by the insurer. Two such options include converting the lapsed policy to an "extended term" equal to that of applying the cash value earned to date in the policy by buying a short-term life insurance policy which uses up the earned cash value to date or by reducing the amount of the policy death benefit.

If the policy lapses, with the extended term option, if the extended term period payments are used up before the insured dies, the policy becomes worthless and no benefits are due the beneficiary. If the insured dies before the extended-term payments are used up, the beneficiary will receive the value of the extended term death benefit. It is the responsibility of the beneficiary to provide a copy of the insured deceased's death certificate to the insurance company as part of the claim procedure to verify the deceased's death and prove the date of death. There is no time limit during which a beneficiary must claim a paid up whole life benefit.

After several years pass and if no beneficiary claims a deceased's policy death benefit, sometimes depending upon the state and the honesty and ethics of the life insurance company, the money may be transferred to the state government in the state where the policy was purchased. If a company knows an insured died and it cannot find the beneficiary, according to law it must turn the full death benefit over to the state Comptroller's Department within three to five years of the insured's death. The money is transferred to the state where the insured bought the policy. The money is considered "unclaimed property" and gets lumped in with dormant bank accounts and uncollected rent deposits. The comptroller's department maintains a database that lists the names and addresses of lost beneficiaries.

Many states will try to contact beneficiaries in an effort to pay the death benefits. Many states will make an effort to contact beneficiaries in an effort to pay the death benefits or at the least make the information available if not publish relevant information conducive to locating, finding and/or being able to pay out the benefits to beneficiaries. In some states the office of the state Treasurer or Comptroller has a web site where any unclaimed death benefits owed can be found.

Keep in mind your chances of finding the policy with a state are slim. The insurance company generally has no obligation to hand the money over to the state if it's unaware that the insured died. In most cases, it's generally the beneficiary who must contact the insurance company. It is alleged that the insurer transfers the money to the state three to five years after it finds that the insured died and is unable to find the beneficiary. There are good reasons, (whether true or not), if the insurer does not turn the death benefit over to the state and if the question should ever arise as to why not, the insurer can indicate that they didn't know the policyholder had died or are still looking for the beneficiary. Furthermore, as previously indicated and ascertained as extremely questionable, many life insurers represent and claim that they aggressively search for beneficiaries of unclaimed benefits and accordingly indicate turning over life insurance policy benefits to a state after the death of an insured is extremely rare as their investigative procedures generally always locate the beneficiaries and that less than 1 percent of insurers death benefits go unclaimed.

Old unclaimed whole life and fully paid up insurance policies don’t go away. If a company knows that an insured died and cannot find the beneficiary, it must turn the full death benefit over to the state Comptroller's department within three to five years of the death. The money is transferred to the state where the insured bought the policy. The money is considered "unclaimed property" and gets lumped in with dormant bank accounts and uncollected rent deposits. The state Comptroller's Department generally maintains a database that lists the names and addresses of lost beneficiaries. When states receive these death benefits, each state has their own system for the handling of these proceeds. Generally, most if not all of the money is transferred into the state's Treasury general and/or reserve fund and is used to pay for state services. Money is allocated to the Department that handles unclaimed property to pay claims if/when the beneficiaries show up to collect the claim. Many states will try to contact beneficiaries in an effort to pay the death benefits.

There are many life insurance experts that support the position that upwards of 25-30% of paid up policies unclaimed life insurance benefits go unclaimed. In sharp contrast there are many life insurance companies whose positions on this matter indicate that it is extremely rare that death benefits are handed over to the state as they indicate that less than 1% of life insurance company’s death benefits go unclaimed as they generally indicate that their companies are usually able to locate the beneficiaries. Whether it is 1% or 25%-30% of paid up life insurance benefits that go unclaimed that are with insurance companies and supposed to be with and under the safekeeping of the state governments Treasury needs to be thoroughly investigated by trustworthy state and federal enforcement and independent authorities. Regardless of whether its 1% or 25%-30%, these unclaimed benefits need to be in the hands of state government coffers and not with life insurance companies where they could easily get lost, misplaced or unaccounted for. And finally, there needs to be one federal agency source which maintains a national database that works with agencies from each state that also maintain a central source and database for their state.

LIFE INSURANCE - THIS SECTION COMPRISES A SELECTION OF ARTICLES BY FORMER INSURANCE COMMISSIONER HERB DENENBERG THAT LETS YOU KNOW ABOUT THE DIFFERENT TYPES, THE INS AND OUTS, AND REAL WORTH OF LIFE INSURANCE POLICIES.

• 1998-12-01  "How To Save Money On Life Insurance By Buying Term Insurance - Part 1"
• 1998-12-01  "How To Save Money On Life Insurance By Buying Term Insurance - Part 2"
• 1999-02-11  "On Life Insurance - Part 1"
• 1999-02-11  "On Life Insurance - Part 2"
• 1999-12-13  "Deceptive Life Insurance Sales Practices Continue Unabated Despite Phony Reforms"

IT'S MORE CORPORATE CRIME AND CORRUPTION, ONLY NOW IT'S ALSO ANTI-CONSUMERS AND ANTI-AMERICANS. No where can we find a civic duty minded politician with a conscience to do anything to correct the breaches of contract and bad faith insurance situation and to protect Americans from bad faith insurers. Don't politicians run for office with good intentions to influence the system and imprint their civic minds for the good of Americans and their constituents? At least that's what they say when they run for public office. (In light of being further duped, again, we have no choice but to go back to the old adage, "actions speak louder than words"). The media and Wall Street have already exposed some of the extreme measures of corporate crime and corruption ... and there is still continued work to be done ... and these companies exposed for their illegal activities and corruption are not exempt from Federal laws and have very little to hide behind except for their own lies. One cannot but only imagine the level of corporate crime and corruption that exists in the Insurance Industry as Insurers are exempt from federal laws, operate behind an unwritten industry wide code referred to as the "Wall of Silence", a business and legal environment where they have had two hundred years of near free reign to be able to rig and manipulate the system to their favor as they desire, and an extremely high paid never ending resource of defense counsel and corporate lawyers which use the courts to hide behind. All of this and blatant conflicts of interest and desperate cries of "foul play" speaks out so loudly to the point that bad faith insurers believe that they are above the law, untouchable and beyond reproach. They have gotten away with their everyday growing number of denials of the truth and cover-ups of the many thousands of bad faith related illegal actions for many years by just denying accusations.

Insurers are predominantly regulated by the states. U.S. Congressional elected Senators and Legislators by law clearly have the right and responsibility to intercede and investigate "where there are state matters such as bad faith in the insurance industry that have fallen between the state government cracks". It is difficult to believe, no it is inconceivable, that there has not been any federal government investigation or intervention. Although The U.S. Commerce Committee has repeatedly been pressured to look into the problem esp. when the State Farm NBC Dateline exposé was aired in June 2000, to date there has been nothing done by The U.S. Commerce Committee under the leadership of Chairman Senator John McCain (R-AZ) and Ranking Member Senator Ernest F. (Fritz) Hollings (D-SC) who at the time indicated they would look into the matter. Is there no one who cares about the American People in our federal congressional, legislative and judicial bodies to test and examine the waters and investigate the millions of accusations that exist on record against bad faith insurers? Because of this, one cannot imagine the level, extent and amount of corporate crime and corruption that exists in the insurance industry today when we see the extreme nature and extent of corporate crime and personal greed in companies that do not have these protections that are misguidedly afforded insurance companies.

Insurers have the same pressures as other publicly traded Wall Street companies to satisfy shareholders, serve customers and satisfy their own personal interests and greed. It is illegal for an Insurer to put their own company's and/or personal interests before insureds and policyholders. FBIC has already shown some of the corruption and duplicity that exists in many of our State Government Agency DOIs throughout the U.S. (click here to read applicable footnotes in this regard following FBIC's Good And Bad Faith Insurer Group List). Certainly, in this light the people cannot count on or look to their State Government Insurance Departments to address this terrible treasure trove of state agency complicity, conflicts of interest and corporate corruption working in tandem and close relationship. Furthermore, it is sad that most Americans apparently feel that elected officials for the most part are not in politics to do what's best for American citizens, their constituents that they represent ... they also share the same feelings that most elected officials are in it for their own personal and self advancement as they too are and have been found upon closer scrutiny to be in bed and close to special interest and corporate campaign donors. It is no secret that the largest campaign finance donors and power brokers on the state level are insurance companies which head the list. Americans need to take back their country ... buying insurance from good faith insurers and boycotting bad faith insurers sends a powerful message and first step in this direction to insurers to stop bad faith insurance practices (and also lets legislators know that they are in their positions to do what's best for Americans ... and not to do what may be best for insurers or for their own personal self-serving agendas and interests and against the best interests of Americans).

Americans need protection from bad faith insurers but it is apparent from politicians lack of action on this front and other areas (i.e. Social Security, Patients Bill Of Rights, etc.) that legislators evidently consider their interests better served right as they presently exist and are best served by doing nothing! We specifically mention social security because it is well known that the U.S. Social Security System is broken and is projected that the Social Security Fund will be completely broke and depleted by year 2015 and yet no one has the incentive to fix it or do anything about it. Possibly, the reason for such inaction by our legislators, if you didn't know is that our country's legislators, congressmen and congresswomen do not pay into Social Security (nor do they collect from it) ... rather they have their own exclusive government retirement plan which upon retirement pays them and their spouse their annual salary for life (plus any increases for cost of living) paid for by, you guessed it, the American People. For example, where the average American might get $1,000 per month paid by the U.S. Government in a social security check, a U.S. Senator or Congressperson gets paid their full salaries (some $3,500 to $5,500 per week on a monthly basis some $12,000 to 22,000) from our tax dollars paid directly to them from the General Funds of the U.S. Treasury for the rest of their lives. Great plan, right ... and their cost for this great plan is "0"! One can only expect that if they didn't have their own exclusive great plan and if they paid into the U.S. Social Security system just as all Americans do, that the U.S. Social Security system would be fixed today and we would not have this looming problem over us.

Our legislators know that bad faith insurance is intrinsically a heavily weighted and significant part of our insurance industry and system. Except for a literal small handful and tiny number of state attorney generals which take up an occasional action or cause against a select insurer(s) on the quiet ... legislators and elected officials do nothing to correct this illegal status quo and instead stick their heads in the sand and acquiesce to the power of the Insurance Industry and where their best personal needs are served. And then when something happens and someone corporate gets caught doing something illegal (I mean really caught where denials don't wash), they are the first to call for a legislative inquiry on television ... as if to say "we had no idea that this was going on" and "see, we care ... look at what we are doing". If our elected officials did care, all they would need to do is read their own mail they receive daily and/or take the initiative to read the volumes and myriad of depositions of insurance company officials testifying in court which tell of how they intentionally duped and defrauded policyholders, read and/or view the increasing number of print and television media exposés of bad faith insurance companies caught live and on-camera with their pants down perpetrating fraud upon claimants and policyholders. (Do you think that the fact that insurance companies are major if not the biggest contributors to the campaigns of state political candidates of both parties has anything to do with it, and that money besides being non-taxable belongs 100% to the candidate win or lose ... or is it possibly that once legislators are voted into office, the real truth of the matter is that by their actions they could care less about the people they are supposedly there to represent, that is their constituents and the People of the United States, and instead are acting it out for the viewing of the voters and in reality are really in it for themselves).

Political experts acknowledge that many if not most legislators and politicians from both the Republican and Democratic Parties know that these bad faith insurance problems exist; that the Democrats blame it on the powerful insurance companies while the Republicans blame it on the plaintiff trial attorneys which they claim are unfairly in it looking only for big court damages awards (as if plaintiff-consumer lawyers can miraculously engineer verdicts to occur in their favor without merit and win big awards for their clients without justification). The experts agree that while both have varying degrees of validity, its easy to recognize and decide which side is only partially and minimally in the right and which side is in the vast majority and is overwhelmingly in the right. They further cite, unfortunately in these cases, that many Republicans have obviously forgotten about the rights of all Americans, Americans whose rights they are supposed to be representing in Congress, and oversight or denial of the existence of the overwhelming many hundreds of thousands and more legitimate claimants cases on the court dockets of those more fortunate to be able to fight and be represented by attorneys. Again, all our politicians need to do is take the initiative to read the depositions of insurance company officials (click here for an example of such court testimony) which tell of how they intentionally duped and defrauded policyholders, watch examples of the increasing number of media exposés of bad faith insurance companies caught live and on-camera perpetrating fraud upon policyholders. NBC Dateline aired the following award winning exposé June 23, 2000 called "The Paper Chase" revealing a myriad of IME bias, deceptive and horrible bad faith insurance claim practices by State Farm Insurance Company which follows. (It is viewed in four parts. Click on each Part, one at a time to view. Each Part is about 15 minutes in length. Please be patient as it may take up to a minute or more to connect and load each part before playing:  Part 1, Part 2, Part 3, Part 4 ). The exposé and report is a strong testament and example of bad faith and fraudulent claim practices by State Farm Insurance Company that contributes in small part to the mass denial of claims by the huge number of other bad faith insurers and mass amount of bad faith insurance that is endemic in the U.S. insurance industry today.

So for now its left to the American People and citizens to organize and do something about it ... its up to us, the millions of Americans, present and former victims, the many tens of thousands more victims being added to the bad faith insurance roles each day, and those others with the foresight and fear of having such a problem happen to them or their family in the future, to support and get behind the FBIC Citizens Action Movement and its members objectives to stop bad faith insurance companies by starting with support of a

of The Hartford, Allstate and State Farm Insurance Companies (also Farmers, Liberty Mutual, Etc.). To participate all that FBIC asks is that you act in your own best interests and cancel your insurance with The Hartford, State Farm or Allstate Insurance Companies now and switch your insurance to another company of your choosing, one which believes in good faith claim settlement practices. (For reference you may possibly want to consider switching your insurance to one of FBIC's rated Good Faith Insurers ... Note: FBIC is not compensated in any way for the insurers good faith rating indicated above). FBIC asks for your support and participation in helping stop bad faith insurance companies, their illegal practices and victimizations against insureds and claimants victims in order not to have to pay legitimate claims, to stand united and empowered in fighting back against all bad faith insurance companies to stop their illegal bad faith claim settlement practices ways. FBIC asks all Americans to join with FBIC’S growing support and membership, friends and neighbors to play a role against all bad faith insurance companies by participating in the "buy-good boycott-bad" faith insurers boycott against The Hartford Insurance Company, State Farm and Allstate, the U.S. rated three worst bad faith insurers, and in so doing send a strong message to insurers and legislators nationwide that the American public demands that bad faith claim settlement practices by all insurers stop immediately!

Professionals in the know blame the Health, HMOs and other related insurance companies for the "lack of care or concern" and for the present near chaos state and impending crisis levels that these insurers are responsible for imposing both on healthcare providers and patients and impacted on our healthcare system today. Hospitals too are feeling the same financial grip of these Insurers as they too have been forced to cut staffs and service, many for the sixth or seventh time in as many years, and in many cases have been forced to close their doors or be acquired to keep their doors open. The sad part is that there is nothing that doctors, pharmacists, nurses and/or the hospitals can do as the Insurers, who have limited general knowledge about healthcare, have the complete and final say in most all cases regarding your health and life, and unfortunately it comes down to if they are willing to put treatment before cost (as they are supposed to in good faith by law) and write the check or not. That decision should be up to Doctors and not decided or determined by insurance company and executive greed. Simply and according to reasonable guidelines and as long as the policy covers the procedure, if the patient's medical procedure has the support (of a number) of expert medical practitioners and specialists, then the decision to have the procedure or operation performed should be left to the patient to make and not be left solely in the hands of the managed healthcare insurer as insurers rule and dictate. The NBC Today Show on December 8, 1998 was one of the first (if not the first) to air and expose an example as this commonly happens. Click here to read the brief transcript of the interview of Karen Johnson, her life threatening cancer, the ordeal and refusal by her managed healthcare insurer, Humana Healthcare to cover the costs of the recommended treatment and procedure indicated by her doctor ... and the finding by the jury that Humana acted improperly in it's decision not to approve her doctor's prescribed (much costlier) treatment.

FBIC, its members and the American People are equally outraged and up to the task of fighting Bad Faith Health Insurers and changing the healthcare system to their advantage and for the better, and separate from insurance company financial decisions. There are so many changes that are needed that it is difficult to decide where to start first to undue the mess that the health insurers and HMOs have made of our healthcare system in such short time or whether just to scrap the whole system and start all over. But there is one thing we know for certain and that is no (health) insurance company should have the absolute power and responsibility and right to play conflicting roles in deciding the fate of your healthcare and life as well as whether to write the check on behalf of the patient or not to write the check and deny the benefit to the advantage of their bottom line profit, its owners and/or shareholders.

For your interest, during the recent decade and going forward, the health insurers and HMOs have reduced the amount of the fees paid to physicians and pharmacies ... in fact, physicians have seen their fees cut by more than half, in many cases have trouble getting paid, and are unable to pay the costs related to running their office and practice, let alone eke out a reasonable living. Doctors in many cases have had to drop accepting certain patients healthcare insurance plans as many have found themselves close to shuttering their office doors as a result of their not being paid. It is not unusual in some of these cases that physicians have been forced to wait upwards of one to two years to get paid by certain health insurers and/or have to sue and bring the insurer to court to collect the large unpaid outstanding balances owed them and other physicians by specific health insurer(s). In other cases, attorney generals have intervened and sued individual health insurers and HMOs on behalf of doctors in order to get physicians paid as a result of complaints by the citizenry that no doctors accept their plan anymore in their area as a result of the health insurer not paying the doctor for many months or year(s) for professional medical services rendered.

To add insult to injury and make matters worse, many physicians have seen their medical malpractice premiums soar unnecessarily to heights without justification or reason (other than the insurers own greed) that it has forced many physicians from practicing. (A recent study by the United States Government General Accounting Office (GAO) finds no substantive reason for the hikes in medical malpractice premiums). Doctors have seen their Managed healthcare bills go unpaid for such extreme and untold amounts of time, that they are no longer in these cases able to continue to accept the specific managed healthcare providers' plan in their office ... at this point the patient has to either pay the physician themselves at the time of the office visit or procedure or not be able to see their physician at all if they can't afford to pay the doctor themselves. But yet in these cases, the insured must continue to pay their health insurance premiums on time or be cancelled. A number of doctors have told us stories of performing medical procedures for patients after having received written authorization from the insurer, only to find out sometime after performing the procedure that the insurer refuses to pay. The list does not stop here.

In addition, pharmacies and pharmacists have also seen their "reimbursement rates" (this is the total fee and profit above the cost of the medication allowed and paid by Health Insurers to pharmacies for filling a prescription) presently cut to as low as $1.40 -$2.00 per prescription and are going lower down to $ zero ... that's right "0". (The "zero" PBMs, Pharmacy Benefit Managers as they are referred to in the industry, substantiate their zero/no fee reimbursement payment structure to participating pharmacies by indicating that they bring customers into stores and those customers buy additional non-prescription products. Merck-Medco owned by the drug company Merck is reported to be one of those zero PBMs. FYI, Merck's and its Merck Medco Division's reputation has come under attack and in question as it was reported in The Wall Street Journal and other media in 2002 that Merck was erroneously including Merck Medco's customer co-pays in its financials thereby deceptively inflating its revenues, has not been reporting manufacturer drug rebates thereby not accurately reflecting the true cost of drugs to consumers, along with other practices i.e. directing consumers toward the use of more expensive competitive select drugs, which are to their benefit and counter-productive to lowering healthcare costs ... its these reasons and more being exposed that they want to get rid of and unload the Medco unit?) How long can the costs of managed care premiums continue to unnecessarily increase before consumers are unable to afford the cost of healthcare? How much longer before all managed care consumers have no other choice but to have their prescriptions filled by mail order pharmacies that are owned by health insurance companies? How much longer before consumers are unable to afford the ever increasing dollar amounts of their copays being charged them by their health insurance companies? How much longer before independent and chain retail pharmacies are forced to close and cease to exist as we know them especially as consumers have become accustomed to rely on their local pharmacist and pharmacy? How much longer before hospitals are forced to close and doctors as we know them cease to exist because insurers have made it economically unfeasible and no longer viable to continue to provide service? How much longer before drug manufacturers can no longer afford to research and develop new drugs as insurers refuse to pay for the high-priced manufactured drugs which have shown to be so successful in extending the duration and increasing the quality of our lives? All of this is certainly not being done as cited to lower healthcare costs or to save the consumer moneys, but for the insurers to make greater and increased profits.

Managed healthcare patients are also getting squeezed by the health insurers in every way possible. Contrary to popular thinking, the "increasing" co-pay amounts that patients are being asked to pay, e.g. to pharmacies for filling their prescriptions, is not retained by the pharmacy as part of their profit but rather deducted from the amount owed by the managed healthcare insurer when they send pharmacies a check for the cost of the drug dispensed and payment of the amount owed for filling the prescription(s). The low reimbursement rates cited is the primary reason why most of our country's local and independent neighborhood pharmacies have been forced to close. The fewer pharmacists staffing the remaining primarily chain store pharmacies are stressed and taxed to the limit as in most cases they are forced to fill the many hundreds if not thousands of prescriptions each store fills each day for their growing number of customers who no longer have the choices of pharmacies to get their prescriptions filled. Patients have seen payment of their claims more often rejected and benefits refused ... many of them putting policyholders under life threatening circumstances ... but unfortunately for insureds bad faith insurer fraud doesn't stop here ... it just begins.

In addition, bad faith health insurers have come up with schemes which experts indicate are nothing more than scams, frauds perpetrated which were created and are widely used by bad faith insurers to be able to make greater profits and/or deny claims. One of many but most recent is in the pharmacy drug dispensing arena an example of which follows. For the most part, managed healthcare consumers know that when paying for a prescription, most have to pay an established lower copay amount for a generic drug and a higher copay amount for a brand drug. Some managed healthcare insurers have found an interesting and deceptive but possibly unlawful way to actually profit from a pharmacy/pharmacist filling and dispensing a low cost drug. It was recently revealed and learned by FBIC of one such recent and apparently new practice and example when a pharmacist dispensed a prescription for two pills, the direct cost of which was $0.16 (16 cents). The prescription was processed by the pharmacy's computer to the PBM's managed healthcare company's computer and returned to the pharmacy computer revealing the following information ... that the PBM managed healthcare insurer company confirmed the total cost of the medicine or drug to be sixteen cents ($0.16) for reimbursement, plus it was reimbursing $1.00 to the pharmacy as the reimbursement rate for filling the prescription, in addition to a $8.84 (hidden) charge designated as "difference" for the medicine bringing the customer's copay up to their preset $10.00 copay level. In this case, the pharmacy as is usual and customary was to keep the $0.16 reimbursement for the cost of the medicine and the $1.00 charge for filling the prescription but that the $8.84 difference was ultimately to be reflected upon invoice and go back to the PBM managed healthcare company subject to collecting the $10.00 copay from the customer. This is outrageous and as other schemes that have been implemented by PBMs will most likely become another standard operating procedure by health insurers to further profit at the consumers expense in such low cost drug cases. And if you thought about it, this scheme could easily work with higher priced drugs and wouldn't you know in the past year or two (2002-2003), the PBMs and the health insurers have come up with multi-tier copays systems which usually depend upon the price of the drug.

With the managed care multi-tiered prescription copay system, we are sure that the health insurers and PBMs could come up with a list of reasons for the format some of which might even have some logic and make sense to some which is rare in a managed healthcare system that is so complicated (just the way the insurers like and want it to be) where generally very little or nothing makes any sense. As a possible example, whether the prescription dispensed is a generic tier 1 drug (i.e. a possible $10.00 copay); a preferred PBM approved mid-priced brand name tier 2 drug (i.e. a possible $20.00 copay) vs. a non-preferred PBM mid-priced brand name tier 2 drug that is competitive with the same tier 2 PBM preferred drug, the copay could be higher (i.e. instead of a possible $20.00 copay for the preferred PBM approved drug, the copay for the competitive non-preferred PBM drug could possibly be $40.00-60.00 copay or could be even higher, the actual cost of the drug, if higher); a preferred PBM approved higher priced brand name tier 3 drug (i.e. a possible $40.00 copay) vs. a non-preferred PBM higher priced brand name tier 3 drug that is competitive with the same tier 3 PBM preferred drug, the copay could be higher (i.e. instead of a possible $40.00 copay for the preferred PBM approved drug, the copay for the competitive non-preferred PBM drug could possibly be $60.00-80.00 copay or could be even higher, the actual cost of the drug if higher). Now we would like to pose a scenario to you that very possibly may have already happened to you and/or may have already experienced. What would you say if the health insurer (actually it may be the PBM) rejected the non-preferred PBM drug and your pharmacist told you when you arrived at the store to pick up your prescription that the health insurance wanted you/your doctor to switch to the competitive preferred drug at the preferred copay rate of $40.00. So you'd be upset while you were inconvenienced calling the MD, etc, etc., etc., having to do all of this taking a whole lot of time and then once finally approved, having to wait further for the pharmacist to change the prescription, do the required due diligence and then process the new drug through your insurance and fill the prescription while all this time waiting, waiting, waiting. While you were waiting you found out by accident that the preferred drug you were now going to be getting was actually a considerably more expensive drug (i.e. $40-$80 or more) than the drug you had been getting up until now. All of this only to be made to get a more expensive drug at the same regular copay that you have been paying. You would be very puzzled and maybe scratch your head as you thought managed healthcare was supposed to lower costs but no bother, you were already very late to wherever you were going and rushed out of the store and on your way. Of course, the reasonable question to ask is "why would a health insurer insist that you get a more expensive drug? Could it have anything to do with huge multi-million dollar rebate programs (or kickback programs whichever be your preference) that upon agreement may be covertly being paid by drug manufacturers to PBMs with possibly some part discreetly and/or secretly being paid out from PBMs to health insurer(s)?

One other example which indicates just how far managed healthcare bad faith insurers will go to make more money and not to have to pay claims and how widespread the bad faith insurance infrastructure is in the U.S. and that patients of managed healthcare don't know about is the huge rebate programs that drug manufacturers silently agree to, in order to have their drugs included in the insurers formulary (drugs that the insurer will accept for payment) so in essence the cost of the drug as represented by the insurers are not their true costs. These rebate programs are good if they help to lower costs however since these rebate programs are kept so secretive, one has to believe that by their secretive nature can only foster further suspicion and belief that healthcare insurers are engaged in illegal activity to further increase their financial gains. This secretive practice and the figures associated with the process along with other insurers covert practices need to become more exposed and more forthcoming especially as it relates to insurers practices in general and the industry bottom line. Insurers need to be more open and forthcoming as to their company practices and more honest and transparent as it relates to costs and their company's bottom lines.

FBIC was proud and pleased when on August 4, 2004, New York Attorney General Eliot Spitzer and New York State Civil Service Commissioner Daniel E. Wall announced a lawsuit against Express Scripts, Inc., ESI Mail Pharmacy Service, Inc., Connecticut General Life Insurance Company and Cigna Life Insurance Company Of New York for conducting elaborate schemes that inflated by millions of dollars the costs of prescription drugs to New York State's largest employee health plan, the Empire Plan. Express Scripts is the nation's third largest pharmacy benefit manager. "The lawsuit alleges that Express Scripts:

• Enriched itself at the expense of the Empire Plan and its members by inflating the cost of generic drugs;
• Diverted to itself millions of dollars in manufacturer rebates that belonged to the Empire Plan;
• Engaged in fraud and deception to induce physicians to switch a patient's prescription from one prescribed drug to another for which Express Scripts received money from the second drug's manufacturer;
• Sold and licensed data belonging to the Empire Plan to drug manufacturers, data collection services and others without the permission in violation of the State's contract;
• Induced the State to enter into the contract by misrepresenting the discounts the Empire Plan was receiving for drugs purchased at retail pharmacies.

While pharmacy benefit managers (PBMs), including Express Scripts, have been under increasing scrutiny by federal and state regulators and law enforcement agencies, New York is the first to allege that Express Scripts enriched itself at its client's expense through a complicated pricing scheme. The scheme hinged on Express Scripts' ability to manipulate its pricing arrangements with its clients." The New York State Department of Civil Service (DCS) administers the Empire Plan and, since 1998, has contracted with Connecticut General Life Insurance Company (CIGNA) to manage the Plan's prescription drug benefit. CIGNA, which is also named as a defendant in the State's lawsuit, subcontracts with Express Scripts to administer the operation of the program. Express Scripts is paid a per claim administration fee for processing the prescription drug claims of Empire Plan members. Express Scripts is also responsible for negotiating the prices of drugs with pharmacies that fill prescriptions for Plan members, and for collecting and passing on to the Plan any rebates that it receives from drug manufacturers as a result of Plan members' use of the manufacturers' drugs. Express Scripts provides PBM services for approximately 52 million people in approximately 19,000 client groups that include health maintenance organizations, health insurers, third-party administrators and government health programs. From 1998 to 2003, Express Script's revenues from its PBM services were in excess of $46 billion. CIGNA is among the largest insurers in the United States. The CIGNA network of companies collected over $15.7 billion in premiums and fees nationally in 2002. Click here to view the press release issued by The Office Of New York State Attorney General Eliot Spitzer on August 4, 2004 regarding the complaint and lawsuit;   click here to view the lawsuit and complaint.  Its well worth the read for consumers to see the extensive number of counts and the enormous amount of dollars involved in the alleged frauds and bad faith insurance committed ... and that amount just involves the fraud committed against the Empire Plan.  Can you imagine the amount of consumer and tax dollars involved when considering all of the bad faith HMOs, Health insurers, the big four national PBMs (Medco, Express Scripts, AdvancePCS, Caremark), etc. throughout all 50 states?  (Note: Adobe Reader is required to view the lawsuit/complaint. Click here to download a free version of Adobe Reader.)

The four largest Pharmacy Benefit Managers or Management Companies aka PBMs (Medco, Express Scripts, AdvancePCS, Caremark) are constantly referenced in the media as they dominate the prescription drug and Managed care industry. The big four national PBMs are expected to be referenced soon as the big three as it was reported on March 24, 2004 that Caremark, the #4 largest PBM completed their purchase of the #2 much larger AdvancePCS as the consolidation is expected to now result in Caremark, Medco and Express Scripts being the three largest in the industry.  The industry's leading companies, including Caremark, have been besieged with lawsuits starting in 2003 with allegations and accusations of fraud, deceptions, anti-trust violations, etc. Furthermore, it is speculated that the much smaller #4 Caremark, being substantially smaller than the #2 and much larger AdvancePCS, needed to come up with a large amount of its own additional capital or additional deep-pocketed resources in order to make the acquisition of the much larger and profitable AdvancePCS.  Interestingly, Caremark upon announcing their intentions to purchase the much larger AdvancePCS in 2003 simultaneously indicated that they would be moving their corporate offices to Nashville, TN. Nashville, FYI, is also home to HCA. HCA is the well-known and notorious Nashville based Hospital Corporation of America which holds the title of being the #1 perpetrator committing the largest fraud amount ever in history against Medicare and others which took place over a multiple year period. If for some reason that rings a bell or sounds familiar, it may be because Tom Frist, Jr. has been credited with being responsible for Caremark's move to Nashville along with numerous reports that lead to the alleged expectations that Caremark has established strong ties with Tom Frist, Jr., who is also founder of HCA with very deep pockets (along with father and founder Tom Frist, Snr. and any other related Frist family members. Tom Frist, Jr. coincidentally is the brother to William "Bill" Frist, U.S. Senator and Senate Majority leader. Senator Frist allegedly did not work for HCA but strangely and instead worked for a cross-town rival Nashville Hospital and allegedly had no involvement in HCA nor did he participate or have knowledge of the frauds committed by HCA against Medicare and others although it is further reported that he has admitted to having stock in the family founded HCA which supposedly is required to be held in a blind trust). Knowing all of this, it would be difficult to connect the dots and not come up with a very suspicious, suspect and uneasy disturbing feeling. In addition, FYI, we couldn't help but to include one final note of information and interest, reported by The Nashville Tennessean newspaper, that "Caremark was originally founded under the name MedPartners in 1993 by former Healthsouth CEO Richard Scrushy and other investors. Former Healthsouth CEO Richard Scrushy is presently under an original 85-count criminal indictment which recently had perjury and obstruction of justice charges added to allegations of fraud and related charges. The indictment alleges he masterminded a $2.7 billion fraud by Healthsouth Corp. which trial is scheduled to begin Jan. 5, 2005. Nineteen people, including several former top executives, have faced criminal charges in connection with the scandal since it surfaced in March 2003, seventeen of which have entered guilty pleas.

Another one of numerous schemes and practices used by bad faith health and workers compensation insurers to be able to deny patient claims and/or not to have to pay for patient medical services is commonly referred to as a "Paper Review". This is when an insurer sends a patient's file to a paper review company supposedly to get an alleged doctor's opinion on the case from a review of the insured's file, without ever having seen or examined the patient ... a pretty good trick. To make this bad faith insurer scam worse, it has recently come to light through the media that it was common practice in many cases that doctors from the paper review companies that were supposed to have reviewed the file, written and/or signed-off on their alleged objective report(s) have in fact never even seen the file ... not written the report(s) and that the reports were signed by clerks (non-doctors) who forged the doctor's signature at the offices of the paper review companies without the doctors having any knowledge. Furthermore, that insurers conferred with these paper review companies on the preferred wording of these reports which were used in court proceedings and/or to deny benefits and claims, further supports and confirms the insurers direct involvement such as the segment produced by NBC Dateline. As previously referenced, the following investigative report produced by NBC Dateline reveals State Farm's inappropriate, deceptive, if not illegal use of biased IME paper reviews attesting to some of the insurer's bad faith and fraudulent claim practices. (Viewed in four parts, click on each part, one at a time to view each 15 minute segment. Please be patient as it make take up to a minute or more to connect and load before playing:  Part 1, Part 2, Part 3, Part 4 ). View it for yourself: numerous, repeated and widespread bad faith and abusive claim practices inflicted nationwide upon the disabled, elderly, patients, as well as consumers, claimants and policyholders. (FYI, paper reviews are IME or independent medical examination reports without ever having seen or examined the patient in-person). After this exposé was made public in June 2000, many of the states DOIs were polled and asked about the practice of insurers using paper reviews. Most indicated that they were not aware of the practice but now with a considerable amount of time gone by we have little to indicate that any of the states and/or their DOI have done anything to stop this deceptive and dishonest, if not illegal practice.

Another example of the flagrant and widespread use of bad faith, abusive and outright practices of fraud by Healthcare Insurers is with the common use of supposed "objective" medical examinations of a claimant patient by a doctor selected and referred to by insurers as independent medical examiners (IMEs). It is a well-known fact that many (most or all) of these doctors, referred to by insurers as "independent medical examiners" that in many or most cases these IME doctors examinations and reports are anything but independent, totally one-sided, partial and not objective at all. For bad faith insurers, this appears to be a similar scam as a "paper review" only here the patient actually "sees" the IME doctor whose bills for their repeated use of their IME services by the insurer are (bought and) paid for by the same Insurer ... continues to use the services of the doctor as long as whatever is written in their examination report, continues to be favorable and acceptable to the Insurer. We repeatedly and constantly hear from patients that the examination amounts to ... in so many words, that "the doctor looks at the patients and in so many words without performing any medical tests is able to reach the same conclusions with patients in a 2-3 minute session basically that there is nothing wrong". FBIC is presently researching IMEs because of the number of repeated horrifying stories each with the same or similar allegations on this subject from consumers, claimants and attorneys.

In spite of these dramatic medical, doctor, pharmacist, hospital and other related patient care cost reductions resulting in a much lower level of care, the cost of Healthcare has skyrocketed, growing at a much higher double-digit rate (i.e. 13-15%) than the single-digit 6% to 8% rate increases prior to the mid-1980s before the recent advent of HMO and health insurers got into the healthcare game. So the question is: where has all the money gone? Insurers like to blame much of the increases on the high costs of new drugs however experts cite that if the responsibility for the decision to pay the high costs primarily for newer drugs was put back into the hands of consumers, many if not most consumers would not pay the high cost and opt for the lower cost drugs alternatives therefore keeping the costs of drugs much lower. Experts cite responsibility for the dramatic increases in Healthcare costs to increased rates charged by insurance companies' in their own greed and search for excessive profits and in part for the enormous salaries, compensation packages and fees paid out to top and senior level insurance company executives, staff lawyers and contract law firms.

The U.S. Government Health Care Financing Administration and other industry sources agree that the managed healthcare system of $1.3 trillion in year 2000 will double to $2.6 trillion by year 2010. In real terms: health insurers continue to greedily increase their fees and piece of the pie presently amounting to upwards of $450 billion per year and approaching a whopping and escalating cost of 30% to Insured Americans for managing today's $1.5 trillion U.S. healthcare system, when the U.S. Federal government manages the 'Medicare' healthcare system for just a 3% cost to Americans. The managed healthcare industry announced admitting openly to having a $4 billion net profit in the year 2001 but yet health insurers continue to charge substantial increases in already expensive premiums as well as make extremely steep increases in copays for prescription drugs in 2003 thereby shifting the burden of these costs to patients. But FBIC does not believe the $4 billion profit figures admitted to by the managed healthcare industry in reality to be much more than they admit. In late 2003, the managed healthcare industry announced operating profits for the first six month period in 2003 to have increased upwards of some 250% to $255 billion attributing the increase to lower costs and increased revenues as they announced projections and are planning for further double-digit increases in premiums for 2004. A former managed healthcare certified public account (CPA) and managed healthcare industry ex-insider, now with the American Institute of Certified Public Accountants (AICPA), indicated that "just as Wall Street companies have their conflicts between their research, brokerage and investment banking arms, insurance companies, who are much less regulated, are free to collude and charge as much as they want for premiums (and various other means) to make as much profit as possible, much moreso than Wall Street companies can do legally. Where it would be illegal for the Wall Street company, it is not illegal for the insurance company to legally deceive and hide as much of their profits as they wish in various and many more ways. The easiest and most common ways employed is just to shift their excessive profits into rising reserves and pay themselves bonuses and other various financial incentive programs, off the books general partnerships, instruments and schemes."

Accordingly and of note regarding the critical and shaky financial condition that the U.S. Medicare system finds itself in these days, all senior and soon to-be senior Americans should feel good about the fact that the U.S. Government seems to be taking a more proactive position in catching fraud and finding a way to be able to take action against the managed healthcare companies who have been caught overcharging the U.S. Medicare system. However, and in being more direct, the only problem is that without personal criminal charges imposed against executives from company's who personally profit and who were responsible for the company's overcharging, these individuals walk away unscathed having gained enormous personal wealth and huge personal profits through such schemes ... and these actions continue to go on and on and to be repeated ad infinitum to the expense of all Americans. Certainly, we should have learned by now that the company found guilty of such actions should be subject to civil fines and penalties so as not to have profited but it is the executives that perpetrated these crimes and directly or indirectly profited from such schemes that should be criminally pursued and punished so as to take away the incentive for their actions and future other executives improper actions. As in the Arthur Andersen case and the 99% of their employees who were honest and lost their jobs, it should be the company that should be allowed to remain and continue on as an operating entity with the Government taking civil actions against it while the corporate officers, executives and individuals responsible and guilty of the fraud from both sides of the table that should be redressed, charged and punished criminally with 100% of all personal profits gained by such actions be taken away along with substantial personal financial penalties imposed).

Disability insurance is another area and part of the healthcare system that many bad faith insurance companies are in a rush to enter since the new millennium because of the huge profits being generated esp. by bad faith insurance companies operating in the field. Disability insurance is insurance where people pay insurers a monthly insurance premium in exchange for the insurer's promise that it will continue to pay insureds a set amount or the amount of their paycheck in the event they should become disabled and unable to work.   FBIC consumer records indicate that disability insurance may be amongst if not the largest and fastest growing areas of bad faith insurance in the U.S. FBIC records and consumer complaints regarding disability bad faith insurer claim cases indicate that it is the exception and not the rule when insureds and claimants have been able to collect disability payments up to a two year period if at all. Of the fortunate few claimant exceptions that indicate that they have been able to collect disability payments, many have reported that they have been harassed by their bad faith insurer and are constantly and repeatedly having to fight with the Insurer in order to have their disability payments continued. A small number of those that are fortunate and able to afford to hire a lawyer report that they had to seek help from an attorney in order to continue to collect disability payments due them during the first two years of their disability. It is further reported in a large number of cases that it is obviously a trend and the exception rather than the rule where claimants are able to collect up to two years. In most of the large number of bad faith disability complaints cases reported, it is indicated to be in the vast minority where the claimant has been able to collect disability payments beyond two years. Many if not most of the significantly reduced numbers of claimants that were able to survive the harassing and annoying insurer conditions and collect up to the two year period report that their benefits were terminated at the two year point, many with threats by alleged bad faith insurers that if the claimant persists to make waves when the payments are stopped, the insurer would start legal proceedings to collect on the two years worth of benefits they had already paid out. Many if not most claimants at this point indicated that they were unable to afford to continue to fight to receive disability payments as they were already destitute and at the point where they were about to lose their home, car, etc. and about to become homeless.

In late 2002, NBC Dateline aired an investigative exposé regarding bad faith insurance and the mass denial of claims by UnumProvident Insurance Company (aka Unum), the largest disability insurer in the U.S. The published transcript and segment is entitled "What if your disability benefits were suddenly cut off?" Correspondent John Larson reports in this Dateline investigation, "Insurance — we buy it for peace of mind to cover our homes, our health, our lives. Millions of Americans have disability insurance to help replace lost income in case of a serious illness or injury. If you can’t work, those benefits may be crucial for you and your family. But what if, suddenly, unexpectedly, your benefits were cut off? That’s what happened to the people in this story. We found some startling charges against the biggest disability insurance provider in the country." Click here to view the NBC Dateline segment called "Benefit Of The Doubt" revealing illegal and fraudulent bad faith insurance practices and the mass denial of claims by the country's largest disability insurer, UnumProvident.

Also in late 2002 CBS 60 Minutes further exposes UnumProvident with a segment reported by Ed Bradley. Click here to view CBS 60 Minutes report called "Did Insurer Cheat Disabled Clients" which includes interviews with UnumProvident's whistleblower medical director, doctors and employees revealing statements and depositions which exposes and confirms the Company's mass denial of claims wrongdoings and bad faith insurance claim practices. ( Click here to read a copy of the transcript of the same CBS 60 Minutes investigative exposé and segment aired on disability insurer UnumProvident). After viewing either or both of these UnumProvident exposés, it is very difficult to comprehend and/or believe former UnumProvident's CEO at the time as he blatantly denied his company's use of such illegal practices. View the two referenced UnumProvident video exposés and you be the judge! Of note, there are a substantial and growing number of lawsuits and/or cases under investigation against UnumProvident regarding their bad faith and mass denial of claims practices.

Health insurance companies and their high level executives are single-handedly to blame for the country's significant deterioration and worsening of the quality of healthcare services provided and inherent in our healthcare system today. Thanks for keeping the system from falling apart goes to our tiring and stressed to the limit medical doctors, nurses, pharmacists and para-related healthcare professionals, our drug companies coming up with new and better albeit expensive drugs introduced into the market and manufacturers of new technology equipment, all of which have had to fight health insurers in order to succeed. In spite of the success and progress made by these professionals, health insurance companies because of the short-term increased expenses associated with these technological advances have done everything possible to deter patients access to these higher priced advancements. Had it not been for these medical professionals, the quality of our country's healthcare services, which used to be second to none, has become an abomination and been decimated thanks single-handedly to the health insurance companies!

THE PRESCRIPTION DRUG AND MEDICARE IMPROVEMENT ACT OF 2003 AND BEYOND ... A SELLING OUT OF OUR SENIORS?  It is of grave concern that the Bush Administration and dominant Republican Party Congress in haste to be able to say that they came through with their election promise to put through some sort of Senior Drug Program may have made the first step in the selling out of our Seniors on Medicare Over To Managed Healthcare Insurance. Only time will tell but the initial signs already look ominous that it is the beginning step(s) of the dismantling and privatizing of the traditional Medicare program. It is reported that the final version of the legislation will force seniors to leave their present doctors in order to receive the benefits of prescription drug coverage not to mention that the bill gives $12 billion dollars to private health insurers and HMOs at the expense of Medicare. The legislation prevents Medicare from using its huge purchasing power to negotiate lower prices from drug companies and furthermore will cause several millions of retired seniors to lose benefits as their current drug coverage plans with their former employers are dropped. Under the bill it is estimated that upwards of 7 million of our country's poorest seniors will not only face increased prescription drug costs, also will be forced to pay additional co-payments, a portion of them least able to afford will have to pay for the full cost of their medicines, while having to pay an estimated $35 monthly premium. More to come but seniors reportedly have received written communications from the Federal Government and Medicare Office indicating that all seniors are required to select a managed healthcare prescription drug program from a total of upwards of some 41 private insurers approved by Medicare and that if they don't select one by June 1, 2004, they will be assigned to one. Making matters worse, there is little if any information available and provided regarding the costs of each of the different drugs that vary from program to program. Who is going to be the major beneficiaries of the Prescription Drug and Medicare Act of 2003? Seniors? Drug companies? Health insurers, HMO's and Managed Healthcare? The answer unfortunately confirms FBIC's original position, greatest suspicions and worst case scenario ... that seniors for the most part will fare last, if at all, and all the early signs and reports show so far that they will wind up dead last.

A Report by Public Citizen sheds light on the magnitude of the power, forces and money spent behind the scenes to get the Act passed to the benefit of special interest. It is reported that 957 lobbyists employed by Managed Healthcare and the Drug Industry spent $141 million dollars in 2003 ... 431 of the lobbyists had direct (aka revolving door) connections to Congress and the White House as they had previously worked for the federal government including 30 that were ex U.S. Senators. "It is no wonder taxpayers ended up with a bill tailor-made to serve these special interests instead of senior citizens." To read the eye-opening "Press Release", "The Report", and "Appendices" "A and B" and "C and D" to find out the companies, lobbyists and politicians names and behind the scenes players and the amounts of monies, facts and details ... click here for the Press Release; click here for The Report (PDF); click here for Appendix A & B, the drug industry lobbying from 1998 - 2003, HMOs and Health Plans lobbying on the Medicare Modernization Act 2003, the companies and dollars $ involved (PDF), and click here for Appendix C & D, to view the HMOs and drug companies and the army of lobbyists involved with and without revolving door influence and connections (PDF). (Note: Adobe Reader is required to view The Report. Click here to download a free version of Adobe Reader.)

FBIC Membership And Tax-Deductible Donation Information.   FBIC is incorporated and is classified by the I.R.S. as a charitable educational non-profit 501(c)(3) organization. FBIC's online web site information and services are provided free to the Public. To those of you who have been lucky up until now not to have bad faith insurance happen to them, and for those concerned about their fellow Americans who have been and have become the victims of bad faith insurance, and the increasing likelihood of bad faith insurance happening to themselves, their family, friends, relatives or next of kin, FBIC asks for your support by making sure that you only buy insurance from good faith insurers and not from bad faith insurers, and for your help by

FBIC Contact Information, Who We Are And What We Represent.   FBIC (Fight Bad-faith Insurance Companies) comprise a cross-section of successful business people, professionals and other individuals s networked throughout the United States who have one thing in common ... they all have or had legitimate claims that were denied by bad faith insurers who started them on the most abusive, deceptive and illegal merry-go-round rides of their lives many of which are in the courts for more than ten years collecting interest on cases that were already decided by the trial courts years ago but the insurers just don't want to pay.  So the insurers lawyers have been given the task to intentionally delay and drag out the cases, putting off payment for as long as possible .

FBIC wants to help Policyholders and Insureds in every way possible but the costs associated with telephone support and regular mail support are just too costly. The FBIC website has been developed and is still very much an expanding work-in-progress many years after it's inception.  FBIC is prudent and cost conscious. By making online resources and email available helps to keep our operation costs low and efficiency high, makes it so we can be more responsive, help and do our best to serve the U.S. Bad Faith Insurance Community's needs.

For a number of our earlier years, there were those few that expressed concerns that this site might be something other than what it appears, such as some sort of cover for an insurance company or the insurance industry, be assured that there is no hidden agenda and that no individuals from FBIC are connected either with the insurance industry, an insurance company, brokerage, agency or agent, a company that legally represents an insurance company or a business entity of the insurance industry. FBIC does not sell insurance or certify, endorse or warrant insurance products, companies, brokers, agents or vendors and is not a referral service.

FBIC members are Americans, are a diverse group and among the greatest people in the U.S. FBIC members are males and females, both young and senior, rich and poor, some with professional and others non-professional backgrounds, white and blue collar, and of all colors, races and creeds that want and believe in working towards a "true" "honest" and corruption-free and bad faith-free insurance industry (not to exclude the same for a democratic system of government, a justice system built on equality and accessibility for all, an honest, corruption-free and prosperous system of business and capitalism, and a social system that is based upon "equality and fairness" for all such as the founding forefathers of this great country would have wanted ... and hopefully one that would believe in "The Real American Way" as a way of life at the very least had no children living in poverty and where all Americans knew both self-respect and respect for others) and that this site is exactly what it honestly represents it is, A Consumer Advocacy! E-Mail comments to:

MyBadFaithStory@badfaithinsurance.org
Webmaster@badfaithinsurance.org
Admin@badfaithinsurance.org